Scaling Up Impact on Nutrition: What Will It Take?

Abstract

Despite consensus on actions to improve nutrition globally, less is known about how to operationalize the right mix of actions - nutrition-specific and nutrition-sensitive - equitably, at scale, in different contexts. This review draws on a large scaling-up literature search and 4 case studies of large-scale nutrition programs with proven impact to synthesize critical elements for impact at scale. Nine elements emerged as central: 1. having a clear vision or goal for impact; 2. intervention characteristics; 3. an enabling organizational context for scaling up; 4. establishing drivers such as catalysts, champions, system-wide ownership, and incentives; 5. choosing contextually relevant strategies and pathways for scaling up, 6. building operational and strategic capacities; 7. ensuring adequacy, stability, and flexibility of financing; 8. ensuring adequate governance structures and systems; and 9. embedding mechanisms for monitoring, learning, and accountability. Translating current political commitment to large-scale impact on nutrition will require robust attention to these elements.